{"id":16247,"date":"2017-04-28T15:48:03","date_gmt":"2017-04-28T12:48:03","guid":{"rendered":"https:\/\/www.turkcerrahi.com\/?page_id=16247"},"modified":"2026-03-31T17:11:16","modified_gmt":"2026-03-31T14:11:16","slug":"diaphragm-anatomy","status":"publish","type":"page","link":"https:\/\/www.turkcerrahi.com\/en\/general-surgery-articles\/diaphragm\/diaphragm-anatomy\/","title":{"rendered":"Anatomy of the Diaphragm"},"content":{"rendered":"<div id=\"pl-16247\" class=\"panel-layout\"><div id=\"pg-16247-0\" class=\"panel-grid panel-no-style\"><div id=\"pgc-16247-0-0\" class=\"panel-grid-cell\"><div id=\"panel-16247-0-0-0\" class=\"so-panel widget widget_black-studio-tinymce widget_black_studio_tinymce panel-first-child panel-last-child\" data-index=\"0\"><div class=\"textwidget\"><figure id=\"attachment_15494\" class=\"thumbnail wp-caption alignnone\" style=\"width: 720px\"><a href=\"https:\/\/www.turkcerrahi.com\/wp-content\/uploads\/diaphragm-anatomy.jpeg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-15494\" src=\"https:\/\/www.turkcerrahi.com\/wp-content\/uploads\/diaphragm-anatomy-720x540.jpeg\" alt=\"Diaphragm anatomy\" width=\"720\" height=\"540\" srcset=\"https:\/\/www.turkcerrahi.com\/wp-content\/uploads\/diaphragm-anatomy-720x540.jpeg 720w, https:\/\/www.turkcerrahi.com\/wp-content\/uploads\/diaphragm-anatomy-768x576.jpeg 768w, https:\/\/www.turkcerrahi.com\/wp-content\/uploads\/diaphragm-anatomy.jpeg 1024w\" sizes=\"auto, (max-width: 720px) 100vw, 720px\"\/><\/a><figcaption class=\"caption wp-caption-text\">Diaphragm anatomy<\/figcaption><\/figure>\n<p>Image retrieved from Wikipedia on 28 April 2017 under <a href=\"https:\/\/en.wikipedia.org\/wiki\/en:Creative_Commons\">Creative Commons<\/a> <a href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/4.0\/deed.en\">Attribution-ShareAlike 4.0 International (CC BY-SA 4.0)<\/a>. <a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:1113_The_Diaphragm.jpg\">Image's Page<\/a>.&nbsp;<a href=\"https:\/\/cnx.org\/contents\/FPtK1zmh@8.25:fEI3C8Ot@10\/Preface\">OpenStax<\/a> the copyright holder of this work. Some descriptions and labels of the image have been reorganized by <a href=\"https:\/\/www.turkcerrahi.com\/en\/\">turkcerrahi.com\/en<\/a><\/p>\n<div class=\"hrule clearfix\" style=\" height:1px\"><\/div>\n\n<div class=\"panel-group\" id=\"accordionname28\"><div class=\"panel panel-default panel-even\"><div class=\"panel-heading\"><a class=\"accordion-toggle \" data-toggle=\"collapse\" data-parent=\"#accordionname28\" href=\"#collapse280\"><h5><i class=\"icon-minus primary-color\"><\/i><i class=\"icon-plus\"><\/i>CONTENTS<\/h5><\/a><\/div><div id=\"collapse280\" class=\"panel-collapse collapse in\"><div class=\"panel-body postclass\">\n<div class=\"kt-simple-box\" style=\"background-color:rgba(236, 246, 255, 1); min-height:1px; padding-top:15px; padding-bottom:15px; padding-left:15px; padding-right:15px; \"><div class=\"kt-simple-box-inner\">\n<ol>\n<li><a href=\"#definition\">Definition<\/a><\/li>\n<li><a href=\"#is-the-diaphragm-striated-or-smooth-muscle\">Is the Diaphragm Striated or Smooth Muscle?<\/a><\/li>\n<li><a href=\"#borders-of-the-diaphragm\">Borders of the Diaphragm<\/a><\/li>\n<li><a href=\"#crus-of-diaphragm-pl-crura\">Crus of Diaphragm (pl. Crura)<\/a>\n<ul>\n<li><a href=\"#right-crus\">Right Crus<\/a><\/li>\n<li><a href=\"#left-crus\">Left Crus<\/a><\/li>\n<\/ul>\n<\/li>\n<li><a href=\"#diaphragmatic-openings-hiatus-and-structures-pass-through\">Diaphragmatic Openings (Hiatus) and Structures Pass-Through<\/a>\n<ul>\n<li><a href=\"#esophageal-hiatus\">Esophageal Hiatus<\/a><\/li>\n<li><a href=\"#hiatus-of-inferior-vena-cava\">Hiatus of Inferior Vena Cava<\/a><\/li>\n<li><a href=\"#aortic-hiatus\">Aortic Hiatus<\/a><\/li>\n<li><a href=\"#foramen-of-morgagni\">Foramen of Morgagni<\/a><\/li>\n<li><a href=\"#foramen-of-bochdalek\">Foramen of Bochdalek<\/a><\/li>\n<li><a href=\"#other-structures-passing-through-the-diaphragm\">Other Structures Passing Through the Diaphragm<\/a><\/li>\n<\/ul>\n<\/li>\n<li><a href=\"#ligaments-of-the-diaphragm\">Ligaments of the Diaphragm<\/a>\n<ul>\n<li><a href=\"#median-arcuate-ligament\">Median Arcuate Ligament<\/a><\/li>\n<li><a href=\"#medial-arcuate-ligament\">Medial Arcuate Ligament<\/a><\/li>\n<li><a href=\"#lateral-arcuate-ligament\">Lateral Arcuate Ligament<\/a><\/li>\n<\/ul>\n<\/li>\n<li><a href=\"#diaphragm-domes\">Diaphragm Domes<\/a><\/li>\n<li><a href=\"#blood-supply-of-the-diaphragm\">Blood Supply of the Diaphragm<\/a><\/li>\n<li><a href=\"#innervation-of-the-diaphragm\">Innervation of the Diaphragm<\/a><\/li>\n<li><a href=\"#physiology-of-ventilation-and-respiration\">Physiology of Ventilation and Respiration<\/a>\n<ul>\n<li><a href=\"#arterial-blood-gas-sensors\">Arterial Blood Gas Sensors<\/a><\/li>\n<\/ul>\n<\/li>\n<li><a href=\"#embryology-of-the-diaphragm\">Embryology of the Diaphragm<\/a>\n<ul>\n<li><a href=\"#transverse-septum\">Transverse Septum<\/a><\/li>\n<li><a href=\"#pleuroperitoneal-membranes\">Pleuroperitoneal Membranes<\/a><\/li>\n<li><a href=\"#dorsal-esophageal-mesentery\">Dorsal Esophageal Mesentery<\/a><\/li>\n<li><a href=\"#peripheral-margin\">Peripheral Margin<\/a><\/li>\n<\/ul>\n<\/li>\n<li><a href=\"#diaphragmatic-hernias\">Diaphragmatic Hernias<\/a>\n<ul>\n<li><a href=\"#acquired-diaphragmatic-hernias\">Acquired Diaphragmatic Hernias<\/a><\/li>\n<li><a href=\"#congenital-diaphragmatic-hernias\">Congenital Diaphragmatic Hernias<\/a>\n<ul>\n<li><a href=\"#morgagni-hernia\">Morgagni Hernia<\/a><\/li>\n<li><a href=\"#bochdalek-hernia\">Bochdalek Hernia<\/a><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<\/ol>\n<\/div><\/div>\n<\/div><\/div><\/div><\/div>\n\n<h2 id=\"definition\">1. Definition<\/h2>\n<p>The <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemBody&gt;The &amp;lt;strong&amp;gt;diaphragm&amp;lt;\/strong&amp;gt; is a large, dome-shaped musculomembranous (musculotendinous) structure that separates the abdominal and thoracic (chest) cavities....&lt;\/div&gt;&lt;div class=glossaryTooltipMoreLinkWrapper&gt;&lt;a class=glossaryTooltipMoreLink href=https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/diaphragm\/ &gt;Read more&lt;\/a&gt;&lt;\/div&gt;\" href=\"https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/diaphragm\/\" data-mobile-support=\"0\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">diaphragm<\/a> is a musculomembranous (musculotendinous) structure that separates the abdominal and thoracic (chest) cavities. The <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemBody&gt;The &amp;lt;strong&amp;gt;diaphragm&amp;lt;\/strong&amp;gt; is a large, dome-shaped musculomembranous (musculotendinous) structure that separates the abdominal and thoracic (chest) cavities....&lt;\/div&gt;&lt;div class=glossaryTooltipMoreLinkWrapper&gt;&lt;a class=glossaryTooltipMoreLink href=https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/diaphragm\/ &gt;Read more&lt;\/a&gt;&lt;\/div&gt;\" href=\"https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/diaphragm\/\" data-mobile-support=\"0\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">diaphragm<\/a> resembles a parachute. The middle is membranous (parachute fabric), and the edges are muscles (parachute strings). The tendinous middle part of the <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemBody&gt;The &amp;lt;strong&amp;gt;diaphragm&amp;lt;\/strong&amp;gt; is a large, dome-shaped musculomembranous (musculotendinous) structure that separates the abdominal and thoracic (chest) cavities....&lt;\/div&gt;&lt;div class=glossaryTooltipMoreLinkWrapper&gt;&lt;a class=glossaryTooltipMoreLink href=https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/diaphragm\/ &gt;Read more&lt;\/a&gt;&lt;\/div&gt;\" href=\"https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/diaphragm\/\" data-mobile-support=\"0\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">diaphragm<\/a> is called the central tendon (centrum tendineum).<\/p>\n<h2 id=\"is-the-diaphragm-striated-or-smooth-muscle\">2. Is the Diaphragm Striated or Smooth Muscle?<\/h2>\n<p>The muscle tissue that forms the sides of the <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemBody&gt;The &amp;lt;strong&amp;gt;diaphragm&amp;lt;\/strong&amp;gt; is a large, dome-shaped musculomembranous (musculotendinous) structure that separates the abdominal and thoracic (chest) cavities....&lt;\/div&gt;&lt;div class=glossaryTooltipMoreLinkWrapper&gt;&lt;a class=glossaryTooltipMoreLink href=https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/diaphragm\/ &gt;Read more&lt;\/a&gt;&lt;\/div&gt;\" href=\"https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/diaphragm\/\" data-mobile-support=\"0\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">diaphragm<\/a> is a striated muscle (i.e., skeletal muscle). However, the <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemBody&gt;The &amp;lt;strong&amp;gt;diaphragm&amp;lt;\/strong&amp;gt; is a large, dome-shaped musculomembranous (musculotendinous) structure that separates the abdominal and thoracic (chest) cavities....&lt;\/div&gt;&lt;div class=glossaryTooltipMoreLinkWrapper&gt;&lt;a class=glossaryTooltipMoreLink href=https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/diaphragm\/ &gt;Read more&lt;\/a&gt;&lt;\/div&gt;\" href=\"https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/diaphragm\/\" data-mobile-support=\"0\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">diaphragm muscle<\/a> and breathing normally work involuntarily (automatically). Sometimes, voluntary breathing also comes into play. For example, talking, singing, laughing, deep breathing, and whistling. Breathing is also temporarily changed by complex reflexes like yawning, sneezing, straining, belching, coughing, and vomiting.<\/p>\n<div class=\"hrule clearfix\" style=\" height:1px\"><\/div>\n<h2 id=\"borders-of-the-diaphragm\">3. Borders of the Diaphragm<\/h2>\n<p>The <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemBody&gt;The &amp;lt;strong&amp;gt;diaphragm&amp;lt;\/strong&amp;gt; is a large, dome-shaped musculomembranous (musculotendinous) structure that separates the abdominal and thoracic (chest) cavities....&lt;\/div&gt;&lt;div class=glossaryTooltipMoreLinkWrapper&gt;&lt;a class=glossaryTooltipMoreLink href=https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/diaphragm\/ &gt;Read more&lt;\/a&gt;&lt;\/div&gt;\" href=\"https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/diaphragm\/\" data-mobile-support=\"0\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">diaphragm<\/a> attaches anteriorly to the xiphoid process and costal margin, and laterally to the 6th to 12th ribs. The <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemBody&gt;The &amp;lt;strong&amp;gt;diaphragm&amp;lt;\/strong&amp;gt; is a large, dome-shaped musculomembranous (musculotendinous) structure that separates the abdominal and thoracic (chest) cavities....&lt;\/div&gt;&lt;div class=glossaryTooltipMoreLinkWrapper&gt;&lt;a class=glossaryTooltipMoreLink href=https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/diaphragm\/ &gt;Read more&lt;\/a&gt;&lt;\/div&gt;\" href=\"https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/diaphragm\/\" data-mobile-support=\"0\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">diaphragm<\/a> attaches posteriorly to the lateral, medial, and median arcuate ligaments. These ligaments attach to the body of the quadratus lumborum muscle, the psoas major muscle, and the first three lumbar vertebrae, respectively (from lateral to medial) (L1-3).<\/p>\n<p>The posterior side of the <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemBody&gt;The &amp;lt;strong&amp;gt;diaphragm&amp;lt;\/strong&amp;gt; is a large, dome-shaped musculomembranous (musculotendinous) structure that separates the abdominal and thoracic (chest) cavities....&lt;\/div&gt;&lt;div class=glossaryTooltipMoreLinkWrapper&gt;&lt;a class=glossaryTooltipMoreLink href=https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/diaphragm\/ &gt;Read more&lt;\/a&gt;&lt;\/div&gt;\" href=\"https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/diaphragm\/\" data-mobile-support=\"0\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">diaphragm<\/a> is longer than the <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemBody&gt;&amp;lt;h1&amp;gt;Anterior&amp;lt;\/h1&amp;gt;\nAnterior refers to &amp;quot;front&rdquo;, &amp;quot;in front of&rdquo;, or &amp;quot;close to the front&rdquo;. In human anatomy, it refers to the front surface of the body or...&lt;\/div&gt;&lt;div class=glossaryTooltipMoreLinkWrapper&gt;&lt;a class=glossaryTooltipMoreLink href=https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/anterior\/ &gt;Read more&lt;\/a&gt;&lt;\/div&gt;\" href=\"https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/anterior\/\" data-mobile-support=\"0\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">anterior<\/a>. Therefore, in the superior part of the posterior abdominal wall, the <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemBody&gt;The &amp;lt;strong&amp;gt;diaphragm&amp;lt;\/strong&amp;gt; is a large, dome-shaped musculomembranous (musculotendinous) structure that separates the abdominal and thoracic (chest) cavities....&lt;\/div&gt;&lt;div class=glossaryTooltipMoreLinkWrapper&gt;&lt;a class=glossaryTooltipMoreLink href=https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/diaphragm\/ &gt;Read more&lt;\/a&gt;&lt;\/div&gt;\" href=\"https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/diaphragm\/\" data-mobile-support=\"0\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">diaphragm<\/a> is located.<\/p>\n<div class=\"hrule clearfix\" style=\" height:1px\"><\/div>\n<h2 id=\"crus-of-diaphragm-pl-crura\">4. Crus of Diaphragm (pl. Crura)<\/h2>\n<figure id=\"attachment_15492\" class=\"thumbnail wp-caption alignnone\" style=\"width: 720px\"><a href=\"https:\/\/www.turkcerrahi.com\/wp-content\/uploads\/diapragm-crura-crus.jpeg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-15492\" src=\"https:\/\/www.turkcerrahi.com\/wp-content\/uploads\/diapragm-crura-crus-720x540.jpeg\" alt=\"Variations of Diaphragmatic Crura\" width=\"720\" height=\"540\" srcset=\"https:\/\/www.turkcerrahi.com\/wp-content\/uploads\/diapragm-crura-crus-720x540.jpeg 720w, https:\/\/www.turkcerrahi.com\/wp-content\/uploads\/diapragm-crura-crus-768x576.jpeg 768w, https:\/\/www.turkcerrahi.com\/wp-content\/uploads\/diapragm-crura-crus.jpeg 1024w\" sizes=\"auto, (max-width: 720px) 100vw, 720px\"\/><\/a><figcaption class=\"caption wp-caption-text\">Variations of Diaphragmatic Crura<\/figcaption><\/figure>\n<div class=\"hrule clearfix\" style=\" height:1px\"><\/div>\n<p>The crura of the <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemBody&gt;The &amp;lt;strong&amp;gt;diaphragm&amp;lt;\/strong&amp;gt; is a large, dome-shaped musculomembranous (musculotendinous) structure that separates the abdominal and thoracic (chest) cavities....&lt;\/div&gt;&lt;div class=glossaryTooltipMoreLinkWrapper&gt;&lt;a class=glossaryTooltipMoreLink href=https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/diaphragm\/ &gt;Read more&lt;\/a&gt;&lt;\/div&gt;\" href=\"https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/diaphragm\/\" data-mobile-support=\"0\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">diaphragm<\/a> are two musculotendinous structures that connect the mid-posterior part of the <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemBody&gt;The &amp;lt;strong&amp;gt;diaphragm&amp;lt;\/strong&amp;gt; is a large, dome-shaped musculomembranous (musculotendinous) structure that separates the abdominal and thoracic (chest) cavities....&lt;\/div&gt;&lt;div class=glossaryTooltipMoreLinkWrapper&gt;&lt;a class=glossaryTooltipMoreLink href=https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/diaphragm\/ &gt;Read more&lt;\/a&gt;&lt;\/div&gt;\" href=\"https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/diaphragm\/\" data-mobile-support=\"0\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">diaphragm<\/a> to the lumbar vertebrae. The right and left crus converge superiorly in front of the esophagus, so the esophagus and aorta remain between the two crus. The right and left crus are joined by a tendinous arch <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemBody&gt;&amp;lt;h1&amp;gt;Anterior&amp;lt;\/h1&amp;gt;\nAnterior refers to &amp;quot;front&rdquo;, &amp;quot;in front of&rdquo;, or &amp;quot;close to the front&rdquo;. In human anatomy, it refers to the front surface of the body or...&lt;\/div&gt;&lt;div class=glossaryTooltipMoreLinkWrapper&gt;&lt;a class=glossaryTooltipMoreLink href=https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/anterior\/ &gt;Read more&lt;\/a&gt;&lt;\/div&gt;\" href=\"https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/anterior\/\" data-mobile-support=\"0\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">anterior<\/a> to the aorta (median arcuate ligament).<\/p>\n<h3 id=\"right-crus\">Right Crus<\/h3>\n<p>The right crus is longer and wider than the left crus. The right crus attaches to the L1&ndash;3 vertebral bodies.<\/p>\n<h3 id=\"left-crus\">Left Crus<\/h3>\n<p>The left crus attaches to the L1&ndash;2 vertebral bodies. So the left crus is shorter than the right crus.<\/p>\n<p>There are two main variations of the <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemBody&gt;The &amp;lt;strong&amp;gt;diaphragm&amp;lt;\/strong&amp;gt; is a large, dome-shaped musculomembranous (musculotendinous) structure that separates the abdominal and thoracic (chest) cavities....&lt;\/div&gt;&lt;div class=glossaryTooltipMoreLinkWrapper&gt;&lt;a class=glossaryTooltipMoreLink href=https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/diaphragm\/ &gt;Read more&lt;\/a&gt;&lt;\/div&gt;\" href=\"https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/diaphragm\/\" data-mobile-support=\"0\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">diaphragm<\/a> crus. First, both the right and left bundles that surround the esophagus originate from the right crus (~ 60%). In another frequent variation, the right and left crus enclose the esophagus in an &quot;8&quot; shape (~ 40%). These variations are not associated with hiatal hernia frequency and type.<\/p>\n<div class=\"hrule clearfix\" style=\" height:1px\"><\/div>\n<h2 id=\"diaphragmatic-openings-hiatus-and-structures-pass-through\">5. Diaphragmatic Openings (Hiatus) and Structures Pass-Through<\/h2>\n<p>Many structures pass through the <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemBody&gt;The &amp;lt;strong&amp;gt;diaphragm&amp;lt;\/strong&amp;gt; is a large, dome-shaped musculomembranous (musculotendinous) structure that separates the abdominal and thoracic (chest) cavities....&lt;\/div&gt;&lt;div class=glossaryTooltipMoreLinkWrapper&gt;&lt;a class=glossaryTooltipMoreLink href=https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/diaphragm\/ &gt;Read more&lt;\/a&gt;&lt;\/div&gt;\" href=\"https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/diaphragm\/\" data-mobile-support=\"0\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">diaphragm<\/a> or around its edges.<\/p>\n<h3 id=\"esophageal-hiatus\">Esophageal Hiatus<\/h3>\n<ul>\n<li><strong>Esophagus:<\/strong> The esophagus passes through the muscular portion of the <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemBody&gt;The &amp;lt;strong&amp;gt;diaphragm&amp;lt;\/strong&amp;gt; is a large, dome-shaped musculomembranous (musculotendinous) structure that separates the abdominal and thoracic (chest) cavities....&lt;\/div&gt;&lt;div class=glossaryTooltipMoreLinkWrapper&gt;&lt;a class=glossaryTooltipMoreLink href=https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/diaphragm\/ &gt;Read more&lt;\/a&gt;&lt;\/div&gt;\" href=\"https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/diaphragm\/\" data-mobile-support=\"0\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">diaphragm<\/a> at the level of T10, up to 2,5 cm to the left of the midline. The esophageal hiatus is located superoanterior and slightly to the left of the aortic hiatus. The <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemBody&gt;&amp;lt;h1&amp;gt;Anterior&amp;lt;\/h1&amp;gt;\nAnterior refers to &amp;quot;front&rdquo;, &amp;quot;in front of&rdquo;, or &amp;quot;close to the front&rdquo;. In human anatomy, it refers to the front surface of the body or...&lt;\/div&gt;&lt;div class=glossaryTooltipMoreLinkWrapper&gt;&lt;a class=glossaryTooltipMoreLink href=https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/anterior\/ &gt;Read more&lt;\/a&gt;&lt;\/div&gt;\" href=\"https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/anterior\/\" data-mobile-support=\"0\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">anterior<\/a> and lateral borders of the hiatus are formed by the muscular arms of the diaphragmatic crura and the posterior border by the median arcuate ligament.<\/li>\n<li><strong><a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemBody&gt;&amp;lt;h1&amp;gt;Anterior&amp;lt;\/h1&amp;gt;\nAnterior refers to &amp;quot;front&rdquo;, &amp;quot;in front of&rdquo;, or &amp;quot;close to the front&rdquo;. In human anatomy, it refers to the front surface of the body or...&lt;\/div&gt;&lt;div class=glossaryTooltipMoreLinkWrapper&gt;&lt;a class=glossaryTooltipMoreLink href=https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/anterior\/ &gt;Read more&lt;\/a&gt;&lt;\/div&gt;\" href=\"https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/anterior\/\" data-mobile-support=\"0\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Anterior<\/a> and posterior vagal trunk<\/strong><\/li>\n<li><strong>Esophageal branches of the left gastric artery and vein<\/strong><\/li>\n<\/ul>\n<h3 id=\"hiatus-of-inferior-vena-cava\">Hiatus of Inferior Vena Cava<\/h3>\n<p>The hiatus of the inferior vena cava is to the right of the central tendon of the <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemBody&gt;The &amp;lt;strong&amp;gt;diaphragm&amp;lt;\/strong&amp;gt; is a large, dome-shaped musculomembranous (musculotendinous) structure that separates the abdominal and thoracic (chest) cavities....&lt;\/div&gt;&lt;div class=glossaryTooltipMoreLinkWrapper&gt;&lt;a class=glossaryTooltipMoreLink href=https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/diaphragm\/ &gt;Read more&lt;\/a&gt;&lt;\/div&gt;\" href=\"https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/diaphragm\/\" data-mobile-support=\"0\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">diaphragm<\/a> (centrum tendineum), at the level of T8, approximately 2.5 cm to the right of the midline.<\/p>\n<ul>\n<li>Inferior Vena Cava<\/li>\n<li><strong>Right Phrenic Nerve:<\/strong> Phrenic nerves arise from C3-C5 on both sides. They reach the <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemBody&gt;The &amp;lt;strong&amp;gt;diaphragm&amp;lt;\/strong&amp;gt; is a large, dome-shaped musculomembranous (musculotendinous) structure that separates the abdominal and thoracic (chest) cavities....&lt;\/div&gt;&lt;div class=glossaryTooltipMoreLinkWrapper&gt;&lt;a class=glossaryTooltipMoreLink href=https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/diaphragm\/ &gt;Read more&lt;\/a&gt;&lt;\/div&gt;\" href=\"https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/diaphragm\/\" data-mobile-support=\"0\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">diaphragm<\/a> by passing between the lungs and heart. It is both a motor and a sensory nerve. The right phrenic nerve usually crosses the <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemBody&gt;The &amp;lt;strong&amp;gt;diaphragm&amp;lt;\/strong&amp;gt; is a large, dome-shaped musculomembranous (musculotendinous) structure that separates the abdominal and thoracic (chest) cavities....&lt;\/div&gt;&lt;div class=glossaryTooltipMoreLinkWrapper&gt;&lt;a class=glossaryTooltipMoreLink href=https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/diaphragm\/ &gt;Read more&lt;\/a&gt;&lt;\/div&gt;\" href=\"https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/diaphragm\/\" data-mobile-support=\"0\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">diaphragm<\/a> to the right of the inferior vena cava. The left phrenic nerve passes over the pericardium of the left ventricle, perforates the <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemBody&gt;The &amp;lt;strong&amp;gt;diaphragm&amp;lt;\/strong&amp;gt; is a large, dome-shaped musculomembranous (musculotendinous) structure that separates the abdominal and thoracic (chest) cavities....&lt;\/div&gt;&lt;div class=glossaryTooltipMoreLinkWrapper&gt;&lt;a class=glossaryTooltipMoreLink href=https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/diaphragm\/ &gt;Read more&lt;\/a&gt;&lt;\/div&gt;\" href=\"https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/diaphragm\/\" data-mobile-support=\"0\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">diaphragm<\/a>, and distributes to the lower surface of the <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemBody&gt;The &amp;lt;strong&amp;gt;diaphragm&amp;lt;\/strong&amp;gt; is a large, dome-shaped musculomembranous (musculotendinous) structure that separates the abdominal and thoracic (chest) cavities....&lt;\/div&gt;&lt;div class=glossaryTooltipMoreLinkWrapper&gt;&lt;a class=glossaryTooltipMoreLink href=https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/diaphragm\/ &gt;Read more&lt;\/a&gt;&lt;\/div&gt;\" href=\"https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/diaphragm\/\" data-mobile-support=\"0\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">diaphragm<\/a>.<\/li>\n<\/ul>\n<h3 id=\"aortic-hiatus\">Aortic Hiatus<\/h3>\n<ul>\n<li><strong>The aorta<\/strong> passes behind the <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemBody&gt;The &amp;lt;strong&amp;gt;diaphragm&amp;lt;\/strong&amp;gt; is a large, dome-shaped musculomembranous (musculotendinous) structure that separates the abdominal and thoracic (chest) cavities....&lt;\/div&gt;&lt;div class=glossaryTooltipMoreLinkWrapper&gt;&lt;a class=glossaryTooltipMoreLink href=https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/diaphragm\/ &gt;Read more&lt;\/a&gt;&lt;\/div&gt;\" href=\"https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/diaphragm\/\" data-mobile-support=\"0\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">diaphragm<\/a> rather than through it at the level of T12. The aortic hiatus is bounded anteriorly by the median arcuate ligament, laterally by the diaphragmatic crura, and posteriorly by the body of the first lumbar vertebra.<\/li>\n<li><strong>Thoracic Duct (Ductus Thoracicus):<\/strong> The thoracic duct is the largest lymphatic vessel in the body. Ductus thoracicus begins with cisterna chyli (L1-2) at the T12 level and empties into the proximal brachiocephalic vein. The thoracic duct crosses the aortic hiatus along with the azygos vein on its right. Both are <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemBody&gt;&amp;lt;h1&amp;gt;Anterior&amp;lt;\/h1&amp;gt;\nAnterior refers to &amp;quot;front&rdquo;, &amp;quot;in front of&rdquo;, or &amp;quot;close to the front&rdquo;. In human anatomy, it refers to the front surface of the body or...&lt;\/div&gt;&lt;div class=glossaryTooltipMoreLinkWrapper&gt;&lt;a class=glossaryTooltipMoreLink href=https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/anterior\/ &gt;Read more&lt;\/a&gt;&lt;\/div&gt;\" href=\"https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/anterior\/\" data-mobile-support=\"0\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">anterior<\/a> to the vertebral bodies and posterior to the aorta.<\/li>\n<li><strong>Azygos Vein:<\/strong> Azygos vein begins in the L2-T12 interval (with the union of the lumbar and subcostal veins). It ascends in front of and to the right of the vertebral bodies. After passing through the aortic hiatus, it drains behind the superior vena cava (at the level of the right main bronchus). The azygos vein sometimes passes through the right crus.<\/li>\n<li><strong>Hemiazygos Vein:<\/strong> The hemiazygos vein is the symmetrical vein of the azygos on the left. The hemiazygos vein drains into the azygos vein at the level of T9.<\/li>\n<\/ul>\n<h3 id=\"foramen-of-morgagni\">Foramen of Morgagni<\/h3>\n<ul>\n<li><strong>Right and Left Superior Epigastric Artery and Vein:<\/strong> The superior epigastric artery and vein are the continuations of the internal thoracic artery and vein (surgeons call the internal thoracic artery and vein the internal mammarian artery and vein, LIMA, RIMA, LIMV, RIMV). Morgagni&rsquo;s hernia usually occurs through the right foramen of Morgagni (90%).<\/li>\n<\/ul>\n<h3 id=\"foramen-of-bochdalek\">Foramen of Bochdalek<\/h3>\n<p>The foramen of Bochdalek is a fetal diaphragmatic opening. It is also called the lumbocostal triangle. The <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemBody&gt;The &amp;lt;strong&amp;gt;diaphragm&amp;lt;\/strong&amp;gt; is a large, dome-shaped musculomembranous (musculotendinous) structure that separates the abdominal and thoracic (chest) cavities....&lt;\/div&gt;&lt;div class=glossaryTooltipMoreLinkWrapper&gt;&lt;a class=glossaryTooltipMoreLink href=https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/diaphragm\/ &gt;Read more&lt;\/a&gt;&lt;\/div&gt;\" href=\"https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/diaphragm\/\" data-mobile-support=\"0\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">diaphragm<\/a> closes between 8 and 10 weeks of fetal life. As a result, in healthy humans, the foramen of Bochdalek is absent (closed), and no anatomical structure passes through it. (Vincenz Alexander Bochdalek, 1801-1883, Czech Professor of Anatomy)<\/p>\n<p>The base of this triangle is at the edge of the lateral arcuate ligament (level of the XIIth rib), and its <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemBody&gt;&amp;lt;h1&amp;gt;Apex (medicine)&amp;lt;\/h1&amp;gt;\nApex refers to the highest or most pointy end of a cone or pyramid-shaped structure. While the term &amp;quot;tip&amp;quot; is generally used for...&lt;\/div&gt;&lt;div class=glossaryTooltipMoreLinkWrapper&gt;&lt;a class=glossaryTooltipMoreLink href=https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/apex\/ &gt;Read more&lt;\/a&gt;&lt;\/div&gt;\" href=\"https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/apex\/\" data-mobile-support=\"0\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">apex<\/a> is toward the central tendon.<\/p>\n<p>Foramen Bochdalek is the source of the Bochdalek hernia, a <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemBody&gt;&amp;lt;h1&amp;gt;Congenital&amp;lt;\/h1&amp;gt;\nCongenital, present at birth; whatever the reason; whether hereditary or not. Congenital anomalies (diseases); It may be genetic,...&lt;\/div&gt;&lt;div class=glossaryTooltipMoreLinkWrapper&gt;&lt;a class=glossaryTooltipMoreLink href=https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/congenital\/ &gt;Read more&lt;\/a&gt;&lt;\/div&gt;\" href=\"https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/congenital\/\" data-mobile-support=\"0\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">congenital<\/a> diaphragmatic hernia. The other <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemBody&gt;&amp;lt;h1&amp;gt;Congenital&amp;lt;\/h1&amp;gt;\nCongenital, present at birth; whatever the reason; whether hereditary or not. Congenital anomalies (diseases); It may be genetic,...&lt;\/div&gt;&lt;div class=glossaryTooltipMoreLinkWrapper&gt;&lt;a class=glossaryTooltipMoreLink href=https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/congenital\/ &gt;Read more&lt;\/a&gt;&lt;\/div&gt;\" href=\"https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/congenital\/\" data-mobile-support=\"0\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">congenital<\/a> diaphragmatic hernia is the Morgagni hernia. 85% of Bochdalek hernias are on the left, and 15% are on the right (liver).<\/p>\n<h3 id=\"other-structures-passing-through-the-diaphragm\">Other Structures Passing Through the Diaphragm<\/h3>\n<ul>\n<li><strong>The greater and lesser splanchnic nerves<\/strong> pass through the left crus (they originate from T5-10 and T10-11, respectively, and go to the celiac ganglion and superior mesenteric ganglion, respectively).<\/li>\n<li><strong>Hemyazygos vein<\/strong> usually passes through the aortic hiatus, sometimes through the left crus.<\/li>\n<li><strong>Right and Left Sympathetic Truncus:<\/strong> On both sides, they pass behind the median arcuate ligament. They extend from the base of the skull to the coccyx (on either side of the vertebral body). They are important elements of the autonomic nervous system (sympathetic).<\/li>\n<li><strong>Left Phrenic Nerve:<\/strong> Phrenic nerves emerge from C3-C5 on both sides. Phrenic nerves reach the <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemBody&gt;The &amp;lt;strong&amp;gt;diaphragm&amp;lt;\/strong&amp;gt; is a large, dome-shaped musculomembranous (musculotendinous) structure that separates the abdominal and thoracic (chest) cavities....&lt;\/div&gt;&lt;div class=glossaryTooltipMoreLinkWrapper&gt;&lt;a class=glossaryTooltipMoreLink href=https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/diaphragm\/ &gt;Read more&lt;\/a&gt;&lt;\/div&gt;\" href=\"https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/diaphragm\/\" data-mobile-support=\"0\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">diaphragm<\/a> by passing between the lungs and heart. Phrenic nerves are both motor and sensory nerves. The right phrenic nerve crosses the <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemBody&gt;The &amp;lt;strong&amp;gt;diaphragm&amp;lt;\/strong&amp;gt; is a large, dome-shaped musculomembranous (musculotendinous) structure that separates the abdominal and thoracic (chest) cavities....&lt;\/div&gt;&lt;div class=glossaryTooltipMoreLinkWrapper&gt;&lt;a class=glossaryTooltipMoreLink href=https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/diaphragm\/ &gt;Read more&lt;\/a&gt;&lt;\/div&gt;\" href=\"https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/diaphragm\/\" data-mobile-support=\"0\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">diaphragm<\/a> (usually) to the right of the inferior vena cava. The left phrenic nerve passes over the pericardium of the left ventricle and perforates the <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemBody&gt;The &amp;lt;strong&amp;gt;diaphragm&amp;lt;\/strong&amp;gt; is a large, dome-shaped musculomembranous (musculotendinous) structure that separates the abdominal and thoracic (chest) cavities....&lt;\/div&gt;&lt;div class=glossaryTooltipMoreLinkWrapper&gt;&lt;a class=glossaryTooltipMoreLink href=https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/diaphragm\/ &gt;Read more&lt;\/a&gt;&lt;\/div&gt;\" href=\"https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/diaphragm\/\" data-mobile-support=\"0\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">diaphragm<\/a> and is distributed on the lower surface of the <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemBody&gt;The &amp;lt;strong&amp;gt;diaphragm&amp;lt;\/strong&amp;gt; is a large, dome-shaped musculomembranous (musculotendinous) structure that separates the abdominal and thoracic (chest) cavities....&lt;\/div&gt;&lt;div class=glossaryTooltipMoreLinkWrapper&gt;&lt;a class=glossaryTooltipMoreLink href=https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/diaphragm\/ &gt;Read more&lt;\/a&gt;&lt;\/div&gt;\" href=\"https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/diaphragm\/\" data-mobile-support=\"0\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">diaphragm<\/a>.<\/li>\n<\/ul>\n<h2 id=\"ligaments-of-the-diaphragm\">6. Ligaments of the Diaphragm<\/h2>\n<h3 id=\"median-arcuate-ligament\">Median Arcuate Ligament<\/h3>\n<p>The median arcuate ligament separates the esophageal and aortic hiatuses. The union of the right and left crus forms the median arcuate ligament. The median arcuate ligament may be either fibrous or muscular. If it is fibrous, it is easily seen; if it is muscular, it is difficult to distinguish.<\/p>\n<p><strong>Median Arcuate Ligament Syndrome:<\/strong> Normally, the median arcuate ligament passes in front of the aorta at the level of L1. Lower ligament placement causes compression of the celiac artery and celiac ganglia. This leads to abdominal pain and weight loss. The median arcuate ligament is formed by the fusion of the right and left crus with a tendinous arch <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemBody&gt;&amp;lt;h1&amp;gt;Anterior&amp;lt;\/h1&amp;gt;\nAnterior refers to &amp;quot;front&rdquo;, &amp;quot;in front of&rdquo;, or &amp;quot;close to the front&rdquo;. In human anatomy, it refers to the front surface of the body or...&lt;\/div&gt;&lt;div class=glossaryTooltipMoreLinkWrapper&gt;&lt;a class=glossaryTooltipMoreLink href=https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/anterior\/ &gt;Read more&lt;\/a&gt;&lt;\/div&gt;\" href=\"https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/anterior\/\" data-mobile-support=\"0\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">anterior<\/a> to the aorta.<\/p>\n<h3 id=\"medial-arcuate-ligament\">Medial Arcuate Ligament<\/h3>\n<p>The medial arcuate ligaments are located to the right and left of the median arcuate ligament. The psoas major muscle passes behind the <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemBody&gt;The &amp;lt;strong&amp;gt;diaphragm&amp;lt;\/strong&amp;gt; is a large, dome-shaped musculomembranous (musculotendinous) structure that separates the abdominal and thoracic (chest) cavities....&lt;\/div&gt;&lt;div class=glossaryTooltipMoreLinkWrapper&gt;&lt;a class=glossaryTooltipMoreLink href=https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/diaphragm\/ &gt;Read more&lt;\/a&gt;&lt;\/div&gt;\" href=\"https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/diaphragm\/\" data-mobile-support=\"0\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">diaphragm<\/a>. The tendinous arch where the <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemBody&gt;The &amp;lt;strong&amp;gt;diaphragm&amp;lt;\/strong&amp;gt; is a large, dome-shaped musculomembranous (musculotendinous) structure that separates the abdominal and thoracic (chest) cavities....&lt;\/div&gt;&lt;div class=glossaryTooltipMoreLinkWrapper&gt;&lt;a class=glossaryTooltipMoreLink href=https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/diaphragm\/ &gt;Read more&lt;\/a&gt;&lt;\/div&gt;\" href=\"https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/diaphragm\/\" data-mobile-support=\"0\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">diaphragm<\/a> attaches to the psoas major muscle fascia is called the medial arcuate ligament.<\/p>\n<p>The lateral leg of the medial arcuate ligament attaches to the spinous process of L1, and the medial leg to the vertebral bodies of L1-3 with the right crus. The sympathetic chain runs behind the medial arcuate ligament.<\/p>\n<h3 id=\"lateral-arcuate-ligament\">Lateral Arcuate Ligament<\/h3>\n<p>The lateral arcuate ligament is a tendinous arch that connects the <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemBody&gt;The &amp;lt;strong&amp;gt;diaphragm&amp;lt;\/strong&amp;gt; is a large, dome-shaped musculomembranous (musculotendinous) structure that separates the abdominal and thoracic (chest) cavities....&lt;\/div&gt;&lt;div class=glossaryTooltipMoreLinkWrapper&gt;&lt;a class=glossaryTooltipMoreLink href=https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/diaphragm\/ &gt;Read more&lt;\/a&gt;&lt;\/div&gt;\" href=\"https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/diaphragm\/\" data-mobile-support=\"0\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">diaphragm<\/a> to the quadratus lumborum muscle fascia. The lateral arcuate ligament attaches to the 12th rib, while the medial leg attaches to the transverse process of L1. The subcostal nerve, artery, and vein pass behind the lateral arcuate ligament.<\/p>\n<div class=\"hrule clearfix\" style=\" height:1px\"><\/div>\n<h2 id=\"diaphragm-domes\">7. Diaphragm Domes<\/h2>\n<p>The <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemBody&gt;The &amp;lt;strong&amp;gt;diaphragm&amp;lt;\/strong&amp;gt; is a large, dome-shaped musculomembranous (musculotendinous) structure that separates the abdominal and thoracic (chest) cavities....&lt;\/div&gt;&lt;div class=glossaryTooltipMoreLinkWrapper&gt;&lt;a class=glossaryTooltipMoreLink href=https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/diaphragm\/ &gt;Read more&lt;\/a&gt;&lt;\/div&gt;\" href=\"https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/diaphragm\/\" data-mobile-support=\"0\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">diaphragm<\/a> is a musculomembranous (musculotendinous) structure with two domes that separates the abdominal and thoracic (chest) cavities.<\/p>\n<p>The right dome is formed by the liver, the right kidney, and the adrenal gland; the left dome is formed by the spleen, the fundus of the stomach, and the left kidney and adrenal gland. The right dome is slightly higher. In expiration, the right dome is at the level of the 5th rib, and the left dome is at the level of the 5th intercostal space. During inspiration, the striated (skeletal) muscles on the outside of the <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemBody&gt;The &amp;lt;strong&amp;gt;diaphragm&amp;lt;\/strong&amp;gt; is a large, dome-shaped musculomembranous (musculotendinous) structure that separates the abdominal and thoracic (chest) cavities....&lt;\/div&gt;&lt;div class=glossaryTooltipMoreLinkWrapper&gt;&lt;a class=glossaryTooltipMoreLink href=https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/diaphragm\/ &gt;Read more&lt;\/a&gt;&lt;\/div&gt;\" href=\"https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/diaphragm\/\" data-mobile-support=\"0\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">diaphragm<\/a> contract, and the center tendon is pulled down like a parachute.<\/p>\n<div class=\"hrule clearfix\" style=\" height:1px\"><\/div>\n<h2 id=\"blood-supply-of-the-diaphragm\">8. Blood Supply of the Diaphragm<\/h2>\n<ul>\n<li><strong>The superior surface of the <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemBody&gt;The &amp;lt;strong&amp;gt;diaphragm&amp;lt;\/strong&amp;gt; is a large, dome-shaped musculomembranous (musculotendinous) structure that separates the abdominal and thoracic (chest) cavities....&lt;\/div&gt;&lt;div class=glossaryTooltipMoreLinkWrapper&gt;&lt;a class=glossaryTooltipMoreLink href=https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/diaphragm\/ &gt;Read more&lt;\/a&gt;&lt;\/div&gt;\" href=\"https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/diaphragm\/\" data-mobile-support=\"0\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">diaphragm<\/a><\/strong>\n<ul>\n<li>Two branches of the internal thoracic arteries are; pericardiophrenic artery and the musculophrenic artery.<\/li>\n<li>Superior phrenic arteries arising from the thoracic aorta<\/li>\n<li>Intercostal arteries.<\/li>\n<\/ul>\n<\/li>\n<li><strong>The inferior surface of the <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemBody&gt;The &amp;lt;strong&amp;gt;diaphragm&amp;lt;\/strong&amp;gt; is a large, dome-shaped musculomembranous (musculotendinous) structure that separates the abdominal and thoracic (chest) cavities....&lt;\/div&gt;&lt;div class=glossaryTooltipMoreLinkWrapper&gt;&lt;a class=glossaryTooltipMoreLink href=https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/diaphragm\/ &gt;Read more&lt;\/a&gt;&lt;\/div&gt;\" href=\"https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/diaphragm\/\" data-mobile-support=\"0\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">diaphragm<\/a><\/strong>\n<ul>\n<li>Inferior phrenic arteries arising from the abdominal aorta. The main blood supply occurs with these arteries.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>Veins accompany arteries both above and below the <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemBody&gt;The &amp;lt;strong&amp;gt;diaphragm&amp;lt;\/strong&amp;gt; is a large, dome-shaped musculomembranous (musculotendinous) structure that separates the abdominal and thoracic (chest) cavities....&lt;\/div&gt;&lt;div class=glossaryTooltipMoreLinkWrapper&gt;&lt;a class=glossaryTooltipMoreLink href=https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/diaphragm\/ &gt;Read more&lt;\/a&gt;&lt;\/div&gt;\" href=\"https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/diaphragm\/\" data-mobile-support=\"0\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">diaphragm<\/a>.<\/p>\n<div class=\"hrule clearfix\" style=\" height:1px\"><\/div>\n<h2 id=\"innervation-of-the-diaphragm\">9. Innervation of the Diaphragm<\/h2>\n<p>The main nerves of the <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemBody&gt;The &amp;lt;strong&amp;gt;diaphragm&amp;lt;\/strong&amp;gt; is a large, dome-shaped musculomembranous (musculotendinous) structure that separates the abdominal and thoracic (chest) cavities....&lt;\/div&gt;&lt;div class=glossaryTooltipMoreLinkWrapper&gt;&lt;a class=glossaryTooltipMoreLink href=https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/diaphragm\/ &gt;Read more&lt;\/a&gt;&lt;\/div&gt;\" href=\"https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/diaphragm\/\" data-mobile-support=\"0\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">diaphragm<\/a> are the right and left phrenic nerves. The phrenic nerves arise from C3-C5 on both sides. They reach the <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemBody&gt;The &amp;lt;strong&amp;gt;diaphragm&amp;lt;\/strong&amp;gt; is a large, dome-shaped musculomembranous (musculotendinous) structure that separates the abdominal and thoracic (chest) cavities....&lt;\/div&gt;&lt;div class=glossaryTooltipMoreLinkWrapper&gt;&lt;a class=glossaryTooltipMoreLink href=https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/diaphragm\/ &gt;Read more&lt;\/a&gt;&lt;\/div&gt;\" href=\"https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/diaphragm\/\" data-mobile-support=\"0\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">diaphragm<\/a> by passing between the lungs and heart. The phrenic nerves are both motor and sensory nerves. The right phrenic nerve usually crosses the <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemBody&gt;The &amp;lt;strong&amp;gt;diaphragm&amp;lt;\/strong&amp;gt; is a large, dome-shaped musculomembranous (musculotendinous) structure that separates the abdominal and thoracic (chest) cavities....&lt;\/div&gt;&lt;div class=glossaryTooltipMoreLinkWrapper&gt;&lt;a class=glossaryTooltipMoreLink href=https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/diaphragm\/ &gt;Read more&lt;\/a&gt;&lt;\/div&gt;\" href=\"https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/diaphragm\/\" data-mobile-support=\"0\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">diaphragm<\/a> to the right of the inferior vena cava. The left phrenic nerve passes over the pericardium of the left ventricle, perforates the <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemBody&gt;The &amp;lt;strong&amp;gt;diaphragm&amp;lt;\/strong&amp;gt; is a large, dome-shaped musculomembranous (musculotendinous) structure that separates the abdominal and thoracic (chest) cavities....&lt;\/div&gt;&lt;div class=glossaryTooltipMoreLinkWrapper&gt;&lt;a class=glossaryTooltipMoreLink href=https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/diaphragm\/ &gt;Read more&lt;\/a&gt;&lt;\/div&gt;\" href=\"https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/diaphragm\/\" data-mobile-support=\"0\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">diaphragm<\/a>, and branches on the inferior surface of the <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemBody&gt;The &amp;lt;strong&amp;gt;diaphragm&amp;lt;\/strong&amp;gt; is a large, dome-shaped musculomembranous (musculotendinous) structure that separates the abdominal and thoracic (chest) cavities....&lt;\/div&gt;&lt;div class=glossaryTooltipMoreLinkWrapper&gt;&lt;a class=glossaryTooltipMoreLink href=https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/diaphragm\/ &gt;Read more&lt;\/a&gt;&lt;\/div&gt;\" href=\"https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/diaphragm\/\" data-mobile-support=\"0\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">diaphragm<\/a>.<\/p>\n<p>There are also sensory fibers in the peripheral region (going to the 7th-12th intercostal nerves).<\/p>\n<div class=\"hrule clearfix\" style=\" height:1px\"><\/div>\n<h2 id=\"physiology-of-ventilation-and-respiration\">10. Physiology of Ventilation and Respiration, Control of Ventilation (Breathing)<\/h2>\n<p>The terms &quot;respiration&quot; and &quot;ventilation&quot; are sometimes used interchangeably. So let's separate the two first.<\/p>\n<p><strong>Respiration<\/strong> refers to the exchange of oxygen and carbon dioxide between the atmosphere and the whole body (cells), including ventilation. In aerobic respiration, oxygen is used to oxidize organic fuel molecules (i.e., glucose), providing a source of energy (i.e., ATP), as well as carbon dioxide and water.<\/p>\n<p><strong>Ventilation<\/strong> means an exchange of air. Pulmonary ventilation is the physical exchange of air between the lungs and the external environment (atmosphere, etc.). Alveolar ventilation is actually a part of pulmonary ventilation, which is the exchange of gas between the alveoli and the external environment. Thus, the oxygen that comes from the atmosphere to the alveoli passes into the blood, and the carbon dioxide that passes from the blood to the alveoli is expelled.<\/p>\n<p>The most important function of pulmonary ventilation (breathing) is blood gas homeostasis (balance). In other words, it is the adjustment of the partial pressure of oxygen and carbon dioxide in the arterial blood (PO2 and PCO2). The control of ventilation means the control of the air entering the lungs and the breathing rate. In most cases, the partial pressure of carbon dioxide (PCO2) determines the respiratory rate.<\/p>\n<h3 id=\"arterial-blood-gas-sensors\">Arterial Blood Gas Sensors<\/h3>\n<ul>\n<li>Sensors in the aortic and carotid bodies measure PO2 and PCO2.<\/li>\n<li>The <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemBody&gt;&amp;lt;h1&amp;gt;Anterior&amp;lt;\/h1&amp;gt;\nAnterior refers to &amp;quot;front&rdquo;, &amp;quot;in front of&rdquo;, or &amp;quot;close to the front&rdquo;. In human anatomy, it refers to the front surface of the body or...&lt;\/div&gt;&lt;div class=glossaryTooltipMoreLinkWrapper&gt;&lt;a class=glossaryTooltipMoreLink href=https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/anterior\/ &gt;Read more&lt;\/a&gt;&lt;\/div&gt;\" href=\"https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/anterior\/\" data-mobile-support=\"0\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">anterior<\/a> and lateral surfaces of the medulla oblongata in the brainstem measure PCO2 and pH of the cerebrospinal fluid (CSF).<\/li>\n<\/ul>\n<p>The nerves transmit the information from these sensors to the respiratory center in the brainstem. The respiratory center is located in the reticular formation and other parts of the brainstem. The respiratory center controls the respiratory muscles (especially the <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemBody&gt;The &amp;lt;strong&amp;gt;diaphragm&amp;lt;\/strong&amp;gt; is a large, dome-shaped musculomembranous (musculotendinous) structure that separates the abdominal and thoracic (chest) cavities....&lt;\/div&gt;&lt;div class=glossaryTooltipMoreLinkWrapper&gt;&lt;a class=glossaryTooltipMoreLink href=https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/diaphragm\/ &gt;Read more&lt;\/a&gt;&lt;\/div&gt;\" href=\"https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/diaphragm\/\" data-mobile-support=\"0\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">diaphragm<\/a> and intercostal muscles).<\/p>\n<div class=\"hrule clearfix\" style=\" height:1px\"><\/div>\n<h2 id=\"embryology-of-the-diaphragm\">11. Embryology of the Diaphragm<\/h2>\n<figure id=\"attachment_15496\" class=\"thumbnail wp-caption alignnone\" style=\"width: 720px\"><a href=\"https:\/\/www.turkcerrahi.com\/wp-content\/uploads\/diaphragm-embryologic-development.jpeg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-15496\" src=\"https:\/\/www.turkcerrahi.com\/wp-content\/uploads\/diaphragm-embryologic-development-720x540.jpeg\" alt=\"Diaphragm embryologic development\" width=\"720\" height=\"540\" srcset=\"https:\/\/www.turkcerrahi.com\/wp-content\/uploads\/diaphragm-embryologic-development-720x540.jpeg 720w, https:\/\/www.turkcerrahi.com\/wp-content\/uploads\/diaphragm-embryologic-development-768x576.jpeg 768w, https:\/\/www.turkcerrahi.com\/wp-content\/uploads\/diaphragm-embryologic-development.jpeg 1024w\" sizes=\"auto, (max-width: 720px) 100vw, 720px\"\/><\/a><figcaption class=\"caption wp-caption-text\">diaphragm embryologic development<\/figcaption><\/figure>\n<p><a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemBody&gt;The &amp;lt;strong&amp;gt;diaphragm&amp;lt;\/strong&amp;gt; is a large, dome-shaped musculomembranous (musculotendinous) structure that separates the abdominal and thoracic (chest) cavities....&lt;\/div&gt;&lt;div class=glossaryTooltipMoreLinkWrapper&gt;&lt;a class=glossaryTooltipMoreLink href=https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/diaphragm\/ &gt;Read more&lt;\/a&gt;&lt;\/div&gt;\" href=\"https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/diaphragm\/\" data-mobile-support=\"0\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Diaphragm<\/a> embryology should be known to understand <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemBody&gt;&amp;lt;h1&amp;gt;Congenital&amp;lt;\/h1&amp;gt;\nCongenital, present at birth; whatever the reason; whether hereditary or not. Congenital anomalies (diseases); It may be genetic,...&lt;\/div&gt;&lt;div class=glossaryTooltipMoreLinkWrapper&gt;&lt;a class=glossaryTooltipMoreLink href=https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/congenital\/ &gt;Read more&lt;\/a&gt;&lt;\/div&gt;\" href=\"https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/congenital\/\" data-mobile-support=\"0\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">congenital<\/a> diaphragmatic hernias. The <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemBody&gt;The &amp;lt;strong&amp;gt;diaphragm&amp;lt;\/strong&amp;gt; is a large, dome-shaped musculomembranous (musculotendinous) structure that separates the abdominal and thoracic (chest) cavities....&lt;\/div&gt;&lt;div class=glossaryTooltipMoreLinkWrapper&gt;&lt;a class=glossaryTooltipMoreLink href=https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/diaphragm\/ &gt;Read more&lt;\/a&gt;&lt;\/div&gt;\" href=\"https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/diaphragm\/\" data-mobile-support=\"0\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">diaphragm<\/a> develops from four structures:<\/p>\n<ol>\n<li>Transverse septum (<a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemBody&gt;&amp;lt;h1&amp;gt;Anterior&amp;lt;\/h1&amp;gt;\nAnterior refers to &amp;quot;front&rdquo;, &amp;quot;in front of&rdquo;, or &amp;quot;close to the front&rdquo;. In human anatomy, it refers to the front surface of the body or...&lt;\/div&gt;&lt;div class=glossaryTooltipMoreLinkWrapper&gt;&lt;a class=glossaryTooltipMoreLink href=https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/anterior\/ &gt;Read more&lt;\/a&gt;&lt;\/div&gt;\" href=\"https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/anterior\/\" data-mobile-support=\"0\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">anterior<\/a>)<\/li>\n<li>Pleuroperitoneal membranes (posterior-lateral)<\/li>\n<li>Dorsal esophageal mesentery (mesoesophagus)<\/li>\n<li>Peripheral margin (muscular body wall).<\/li>\n<\/ol>\n<h3 id=\"transverse-septum\">Transverse Septum (Septum Transversum)<\/h3>\n<p>Two main structures develop from the transverse septum: the <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemBody&gt;The &amp;lt;strong&amp;gt;diaphragm&amp;lt;\/strong&amp;gt; is a large, dome-shaped musculomembranous (musculotendinous) structure that separates the abdominal and thoracic (chest) cavities....&lt;\/div&gt;&lt;div class=glossaryTooltipMoreLinkWrapper&gt;&lt;a class=glossaryTooltipMoreLink href=https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/diaphragm\/ &gt;Read more&lt;\/a&gt;&lt;\/div&gt;\" href=\"https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/diaphragm\/\" data-mobile-support=\"0\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">diaphragm<\/a> (central tendon) and the <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemBody&gt;&amp;lt;h1&amp;gt;Anterior&amp;lt;\/h1&amp;gt;\nAnterior refers to &amp;quot;front&rdquo;, &amp;quot;in front of&rdquo;, or &amp;quot;close to the front&rdquo;. In human anatomy, it refers to the front surface of the body or...&lt;\/div&gt;&lt;div class=glossaryTooltipMoreLinkWrapper&gt;&lt;a class=glossaryTooltipMoreLink href=https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/anterior\/ &gt;Read more&lt;\/a&gt;&lt;\/div&gt;\" href=\"https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/anterior\/\" data-mobile-support=\"0\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">ventral<\/a> mesentery of the foregut (lesser omentum). The transverse septum derives from mesenchyme. The mesenchyme develops from the mesoderm, which is one of the three main germ layers in the embryo. The germ layer is any of three primary cell layers formed in the earliest stages of embryonic development, consisting of the endoderm (inner layer), the ectoderm (outer layer), and the mesoderm (middle layer).<\/p>\n<h3 id=\"pleuroperitoneal-membranes\">Pleuroperitoneal Membranes<\/h3>\n<p>The pleuroperitoneal membranes are a pair of membranes (on the right and left) that gradually separate the pleural and peritoneal cavities. Pleuroperitoneal membranes arise from the dorsolateral (posterior-lateral) aspect of the body wall. The free margins elongate and fuse with the dorsal mesentery of the esophagus and the transverse septum. Following fusion, myoblasts (myocyte-muscle cell precursors) in the transverse septum infiltrate the pleuroperitoneal membrane and form the <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemBody&gt;The &amp;lt;strong&amp;gt;diaphragm&amp;lt;\/strong&amp;gt; is a large, dome-shaped musculomembranous (musculotendinous) structure that separates the abdominal and thoracic (chest) cavities....&lt;\/div&gt;&lt;div class=glossaryTooltipMoreLinkWrapper&gt;&lt;a class=glossaryTooltipMoreLink href=https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/diaphragm\/ &gt;Read more&lt;\/a&gt;&lt;\/div&gt;\" href=\"https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/diaphragm\/\" data-mobile-support=\"0\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">diaphragm muscle<\/a>.<\/p>\n<h3 id=\"dorsal-esophageal-mesentery\">Dorsal Esophageal Mesentery<\/h3>\n<p>The dorsal esophageal mesentery (mesoesophagus) fuses with both the transverse septum and the pleuroperitoneal membrane. The esophageal mesentery forms the mid-posterior part of the <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemBody&gt;The &amp;lt;strong&amp;gt;diaphragm&amp;lt;\/strong&amp;gt; is a large, dome-shaped musculomembranous (musculotendinous) structure that separates the abdominal and thoracic (chest) cavities....&lt;\/div&gt;&lt;div class=glossaryTooltipMoreLinkWrapper&gt;&lt;a class=glossaryTooltipMoreLink href=https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/diaphragm\/ &gt;Read more&lt;\/a&gt;&lt;\/div&gt;\" href=\"https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/diaphragm\/\" data-mobile-support=\"0\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">diaphragm<\/a>. <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemBody&gt;The &amp;lt;strong&amp;gt;diaphragm&amp;lt;\/strong&amp;gt; is a large, dome-shaped musculomembranous (musculotendinous) structure that separates the abdominal and thoracic (chest) cavities....&lt;\/div&gt;&lt;div class=glossaryTooltipMoreLinkWrapper&gt;&lt;a class=glossaryTooltipMoreLink href=https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/diaphragm\/ &gt;Read more&lt;\/a&gt;&lt;\/div&gt;\" href=\"https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/diaphragm\/\" data-mobile-support=\"0\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Diaphragm<\/a> crus develops from growing muscle fibers within the esophageal mesentery.<\/p>\n<h3 id=\"peripheral-margin\">Peripheral Margin<\/h3>\n<p>In the 9th and 12th weeks, the pleural cavities enlarge and fuse with the lateral body walls. Body wall tissues also differentiate and develop medially (pleuroperitoneal membrane) to form the peripheral part of the <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemBody&gt;The &amp;lt;strong&amp;gt;diaphragm&amp;lt;\/strong&amp;gt; is a large, dome-shaped musculomembranous (musculotendinous) structure that separates the abdominal and thoracic (chest) cavities....&lt;\/div&gt;&lt;div class=glossaryTooltipMoreLinkWrapper&gt;&lt;a class=glossaryTooltipMoreLink href=https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/diaphragm\/ &gt;Read more&lt;\/a&gt;&lt;\/div&gt;\" href=\"https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/diaphragm\/\" data-mobile-support=\"0\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">diaphragm<\/a>. Extensions of the pleural cavities to the body walls form the costodiaphragmatic sinuses (recesses).<\/p>\n<div class=\"hrule clearfix\" style=\" height:1px\"><\/div>\n<h2 id=\"diaphragmatic-hernias\">12. Diaphragmatic Hernias<\/h2>\n<figure id=\"attachment_15490\" class=\"thumbnail wp-caption alignnone\" style=\"width: 720px\"><a href=\"https:\/\/www.turkcerrahi.com\/wp-content\/uploads\/diaphragm-hernia-types.jpeg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-15490\" src=\"https:\/\/www.turkcerrahi.com\/wp-content\/uploads\/diaphragm-hernia-types-720x540.jpeg\" alt=\"Diaphragm hernia types\" width=\"720\" height=\"540\" srcset=\"https:\/\/www.turkcerrahi.com\/wp-content\/uploads\/diaphragm-hernia-types-720x540.jpeg 720w, https:\/\/www.turkcerrahi.com\/wp-content\/uploads\/diaphragm-hernia-types-768x576.jpeg 768w, https:\/\/www.turkcerrahi.com\/wp-content\/uploads\/diaphragm-hernia-types.jpeg 1024w\" sizes=\"auto, (max-width: 720px) 100vw, 720px\"\/><\/a><figcaption class=\"caption wp-caption-text\">Diaphragm hernia types<\/figcaption><\/figure>\n<h3 id=\"acquired-diaphragmatic-hernias\">Acquired Diaphragmatic Hernias<\/h3>\n<ul>\n<li><strong>Hiatal Hernia<\/strong> (through the esophageal hiatus)\n<ul>\n<li>Type 1, sliding hernia (gastroesophageal junction + gastric cardia in the thorax)<\/li>\n<li>Type 2, rolling (paraesophageal) hernia (The GE junction is in its normal position, the fundus of the stomach is in the thorax)<\/li>\n<li>Type 3, mixed type, sliding+rolling (both the GE junction and the stomach fundus are located in the thorax).<\/li>\n<li>Type 4, giant hiatal hernias: the GE junction is in its normal position; most of the stomach, colon, omentum, and spleen are in the thorax.<\/li>\n<\/ul>\n<\/li>\n<li><strong>Diaphragmatic Rupture:<\/strong> Usually occurs with penetrating injury. The hernia may enlarge and give symptoms months and years later.<\/li>\n<li><strong>Iatrogenic Diaphragmatic Hernia:<\/strong> Due to previous abdominal and thoracic surgeries; such as esophagectomy, gastrectomy, nephrectomy, lung lobectomy, and liver resections.<\/li>\n<\/ul>\n<h3 id=\"congenital-diaphragmatic-hernias\">Congenital Diaphragmatic Hernias<\/h3>\n<p>There are two types of <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemBody&gt;&amp;lt;h1&amp;gt;Congenital&amp;lt;\/h1&amp;gt;\nCongenital, present at birth; whatever the reason; whether hereditary or not. Congenital anomalies (diseases); It may be genetic,...&lt;\/div&gt;&lt;div class=glossaryTooltipMoreLinkWrapper&gt;&lt;a class=glossaryTooltipMoreLink href=https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/congenital\/ &gt;Read more&lt;\/a&gt;&lt;\/div&gt;\" href=\"https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/congenital\/\" data-mobile-support=\"0\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">congenital<\/a> diaphragmatic hernias.<\/p>\n<ul>\n<li>Morgagni hernia<\/li>\n<li>Bochdalek Hernia<\/li>\n<\/ul>\n<h4 id=\"morgagni-hernia\">Morgagni Hernia<\/h4>\n<p>The Morgagni hernia occurs just to the right and behind the sternum (remember, the inferior epigastric artery and vein pass through the sternocostal triangle). Morgagni hernias are usually small, and one-third are symptomatic. Morgagni hernias can be detected in adulthood as well. They contain the omentum, the colon, and the stomach.<\/p>\n<h4 id=\"bochdalek-hernia\">Bochdalek Hernia<\/h4>\n<p>The Bochdalek hernia is posterior to the <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemBody&gt;The &amp;lt;strong&amp;gt;diaphragm&amp;lt;\/strong&amp;gt; is a large, dome-shaped musculomembranous (musculotendinous) structure that separates the abdominal and thoracic (chest) cavities....&lt;\/div&gt;&lt;div class=glossaryTooltipMoreLinkWrapper&gt;&lt;a class=glossaryTooltipMoreLink href=https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/diaphragm\/ &gt;Read more&lt;\/a&gt;&lt;\/div&gt;\" href=\"https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/diaphragm\/\" data-mobile-support=\"0\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">diaphragm<\/a> and usually to the left (85%), because the left pleuroperitoneal canal (<a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemBody&gt;The &amp;lt;strong&amp;gt;diaphragm&amp;lt;\/strong&amp;gt; is a large, dome-shaped musculomembranous (musculotendinous) structure that separates the abdominal and thoracic (chest) cavities....&lt;\/div&gt;&lt;div class=glossaryTooltipMoreLinkWrapper&gt;&lt;a class=glossaryTooltipMoreLink href=https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/diaphragm\/ &gt;Read more&lt;\/a&gt;&lt;\/div&gt;\" href=\"https:\/\/www.turkcerrahi.com\/en\/medical-dictionary\/diaphragm\/\" data-mobile-support=\"0\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">diaphragm<\/a>) closes later. The intestines, as is well known, develop outside of the abdomen and then return to the inside. If the pleuroperitoneal membrane is not completely closed when the intestines return to the abdomen (10th week), the intra-abdominal organs pass into the thorax. That is why the child is born with pulmonary hypoplasia. Occasionally, retroperitoneal organs (spleen and kidney) may also pass into the thorax.<br>\n<\/p><div class=\"hrule clearfix\" style=\" height:1px\"><\/div>\n<div class=\"row\"> <div class=\"col-md-6  \">\n<p style=\"text-align: center;\">&lt; <a href=\"https:\/\/www.turkcerrahi.com\/en\/general-surgery-articles\/diaphragm\/\" title=\"Diaphragm\">Diaphragm<\/a>\n<\/p><\/div><div class=\"col-md-6  \">\n<p style=\"text-align: center;\"><a href=\"https:\/\/www.turkcerrahi.com\/en\/general-surgery-articles\/esophagus\/\" title=\"Esophagus\">Esophagus<\/a> &gt;<\/p>\n<\/div><\/div>\n<div class=\"hrule clearfix\" style=\" height:1px\"><\/div>\n<\/div><\/div><\/div><div id=\"pgc-16247-0-1\" class=\"panel-grid-cell\"><div id=\"panel-16247-0-1-0\" class=\"so-panel widget widget_nav_menu panel-first-child panel-last-child\" data-index=\"1\"><div class=\"panel-widget-style panel-widget-style-for-16247-0-1-0\"><h3 class=\"widget-title\">Diaphragm<\/h3><ul id=\"menu-diaphragm\" class=\"menu\"><li class=\" menu-item-16245 menu-item menu-diaphragm-overview\"><a href=\"https:\/\/www.turkcerrahi.com\/en\/general-surgery-articles\/diaphragm\/\"><span>Diaphragm &ndash; Overview<\/span><\/a><\/li>\n<li class=\" menu-item-16253 menu-item menu-anatomy-of-the-diaphragm\"><a href=\"https:\/\/www.turkcerrahi.com\/en\/general-surgery-articles\/diaphragm\/diaphragm-anatomy\/\"><span>Anatomy of the Diaphragm<\/span><\/a><\/li>\n<\/ul><\/div><\/div><\/div><\/div><\/div>","protected":false},"excerpt":{"rendered":"<p>Image retrieved from Wikipedia on 28 April 2017 under Creative Commons Attribution-ShareAlike 4.0 International (CC BY-SA 4.0). Image&#8217;s Page.\u00a0OpenStax the copyright holder of this work. Some descriptions and labels of the image have been reorganized by turkcerrahi.com\/en 1. Definition The &hellip; <a class=\"kt-excerpt-readmore\" href=\"https:\/\/www.turkcerrahi.com\/en\/general-surgery-articles\/diaphragm\/diaphragm-anatomy\/\" aria-label=\"Anatomy of the Diaphragm\">Read More<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"parent":16239,"menu_order":76,"comment_status":"closed","ping_status":"closed","template":"page-fullwidth.php","meta":{"footnotes":""},"class_list":["post-16247","page","type-page","status-publish","hentry"],"aioseo_notices":[],"aioseo_head":"\n\t\t<!-- All in One SEO 4.9.10 - aioseo.com -->\n\t<meta name=\"description\" content=\"The diaphragm is a musculomembranous (musculotendinous) structure that separates abdominal and thoracic (chest) cavities. 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